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Test ID ETGL Ethylene Glycol, Serum


Specimen Required


Collection Container/Tube: Red top (serum gel/SST tubes are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial within 2 hours of collection.


Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Secondary ID

8749

Useful For

Confirming and monitoring ethylene glycol toxicity

Method Name

Gas Chromatography-Flame Ionization Detection (GC-FID)

Reporting Name

Ethylene Glycol, S

Specimen Type

Serum Red

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Clinical Information

Ethylene glycol is present in antifreeze products, deicing products, detergents, paints, and cosmetics. Ethylene glycol has initial central nervous system (CNS) effects resembling those of ethanol and may be ingested accidentally or for the purpose of inebriation or suicide. Ethylene glycol itself is relatively nontoxic, however, metabolism of ethylene glycol by alcohol dehydrogenase (ADH) results in the formation of a number of acid metabolites, including oxalic acid and glycolic acid. These acid metabolites are responsible for much of the toxicity of ethylene glycol.

 

Clinically poisoning has historically been divided into three stages, although timing may vary and stages may overlap. The first stage typically begins 30 minutes to 12 hours after ingestion due to the intoxicating effects of the ethylene glycol and may range from mild CNS depression to coma. The second stage begins 12 to 24 hours after ingestion and is characterized severe metabolic acidosis, due to the accumulation of acid metabolites. The third stage occurs 24 to 72 hours after ingestion and is characterized by renal failure due to calcium oxalate crystal deposition in the proximal tubules.

 

Ethylene glycol toxicity can be treated with 4-methylpyrazole (4-MP; fomepizole) or ethanol by competitively inhibiting alcohol dehydrogenase and thereby preventing conversion of ethylene glycol to its toxic metabolites.

Reference Values

Toxic concentration: ≥20 mg/dL

Cautions

Propionic acid produced in the rare inborn error of metabolism methylmalonic acidemia may be confused with ethylene glycol in the gas chromatographic assay.

 

Specimens collected in serum gel tubes are not acceptable, as the drug/analyte can absorb on the gel and lead to falsely decreased concentrations.

Day(s) Performed

Monday through Sunday

Report Available

2 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80320

G0480 (if appropriate)

NY State Approved

Yes